Listen to our conversation with Dr. Madeleine Healy, a passionate geriatrician and general physician supporting people living with dementia. Madeleine works across Monash Health and HammondCare, bringing her expertise to memory clinics, acute and subacute services, residential aged care, and Dementia Support Australia.

In this episode, Madeleine shares her journey into dementia diagnosis and care, particularly for individuals with Down syndrome. She reveals how her passion for helping those with intellectual disabilities led her to pursue a PhD focused on designing a specialised memory clinic for dementia diagnosis for people with Down syndrome. Her PhD is focused on working with people with Down Syndrome to design a memory clinic that meets their needs. She shares about the symptoms of dementia to be aware of in people living with Down Syndrome and the importance of regular screening to understand changes in memory, thinking and function. People living with Down syndrome now live up to 60 years and are the largest population group that are genetically predisposed to developing dementia. Learn why innovative service models are crucial for providing the care and support this community needs. Tune in to hear Madeleine's insights and the vital work being done to improve dementia care for those most at risk

“We need better cognitive services for people with Down Syndrome and other intellectual disabilities, so that we have equal access to dementia diagnosis and to management and to post diagnostic support.”

Hosted by Darshini Ayton and Sarah Carmody

Produced by Darshini Ayton

Music by Luke Champion

An initiative of the Centre of Research Excellence in Enhanced Dementia Diagnosis which is funded by the Australian National Health and Medical Research Council.

This podcast was recorded on Wurundjeri Country. We acknowledge the Traditional owners and custodians of the Wurundjeri Land, the Boonwurrung and the Woiwurrung peoples of the Kulin Nation. We pay our respect to their Elders past and present. Lands which Sovereignty was never ceded. Always was, always will be Aboriginal Lands.

Associate Professor Yen Ying Lim is a clinical psychologist and researcher. Her primary research interests are in integrating and translating the effects of genetic, biological, and lifestyle factors on cognitive decline and clinical disease progression in Alzheimer’s disease. She is also interested in the development and validation of web-based cognitive tests for the early detection of cognitive dysfunction in preclinical Alzheimer’s disease.

Yen dedicates her dementia research work to people in their midlife (ages 40-70) who have a family history of dementia. She focuses on detecting early signs of Alzheimer's Disease, even in individuals who currently show no symptoms of dementia. This early detection presents a fascinating dilemma. While these individuals can't be officially classified as having early-onset Alzheimer's, they are intriguing cases to study. They might face a heightened risk of developing dementia in the future, though there's also a possibility they may never experience it. Tracking their progress could provide invaluable insights into the onset and progression of dementia.

Yen explains the world of cognitive assessments and how the tests evaluate memory, executive function, attention, language, and processing speed. These assessments offer a window into the brain's intricate workings, capturing a spectrum of cognitive domains to better understand cognitive health.

With the onset of COVID-19, Yen is at the forefront of pioneering online cognitive assessments, responding to the need for flexible, accessible testing. The traditional face-to-face evaluations often require travel, which can be a significant barrier for many. Yen weighs the advantages and limitations of both online and in-person assessments, highlighting how online options can reduce logistical hurdles but may lack the controlled environment of in-person testing.

Yen explains the comprehensive nature of neuropsychological tests and the reasons behind their sometimes unconventional design. However, many existing tests were created for highly educated, Western populations, leading to potential disadvantage among diverse groups. Hence people may score worse on a test, not because of cognition, but because a word in the test is unfamiliar. Yen is deeply committed to dementia research across culturally and linguistically diverse populations. She strives to ensure that cognitive assessments and related advice are both culturally appropriate and sensitive, enhancing their relevance and effectiveness.

"The most important modifiable dementia risk factor is the one that you are willing to address”

Hosted by Darshini Ayton and Sarah Carmody

Produced by Darshini Ayton

Music by Luke Champion

An initiative of the Centre of Research Excellence in Enhanced Dementia Diagnosis which is funded by the Australian National Health and Medical Research Council.

This podcast was recorded on Wurundjeri Country. We acknowledge the Traditional owners and custodians of the Wurundjeri Land, the Boonwurrung and the Woiwurrung peoples of the Kulin Nation. We pay our respect to their Elders past and present. Lands which Sovereignty was never ceded. Always was, always will be Aboriginal Lands.

Associate Professor Michael Woodward is Head of Aged Care Research and the Memory Clinic at Austin Health in Melbourne, Victoria. He is a specialist in geriatric medicine with major interests in the treatment of Alzheimer’s disease (AD) and other dementias. He is Principal Investigator for numerous research trials of new therapies for AD and related disorders.

Michael describes working in aged care as a uniquely holistic approach to medicine, addressing not just the symptoms but the entire well-being of the patient. Michael’s journey into geriatrics and dementia care came through his involvement in various clinical trials where he developed a profound passion for the field. Michael's role involves evaluating patients referred for dementia assessments as a geriatrician and also managing cases in his capacity as a rehabilitation physician, where he often encounters patients who reveal memory issues that predate their surgeries.

When faced with the question, "Is this dementia?" Michael starts with a thorough patient history, engaging with both the patient and their family. This is followed by a series of clinical assessments, cognitive screenings, and routine tests. Michael is fortunate to work at the Austin Hospital in Melbourne, where he has access to cutting-edge diagnostic tools such as amyloid PET scans and specialised blood tests. These advanced facilities allow him to detect biomarkers indicative of Alzheimer’s Disease, ensuring a high level of diagnostic accuracy.

In addition to his clinical work, Michael is dedicated to shaping the future of dementia care by mentoring the next generation of doctors. The field of geriatrics is the fastest growing speciality within the Australasian College of Physicians, yet Michael notes a significant need for specialised dementia training among general practitioners and other specialists, like cardiologists, who work with older people. He also points out the uneven distribution of geriatricians, with a concentration in metropolitan areas compared to rural regions in Australia.

Michael observes that our understanding and management of dementia have evolved significantly over the years. While the time required for a diagnosis has increased compared to twenty-five years ago, the accuracy of diagnoses has improved, allowing for more personalised care. He emphasises the growing importance of dementia support services, such as dementia navigators, to guide individuals through the complex diagnostic and management process.

"I want to have better treatments, and I want the journey for those with dementia to be much better than it is for many of them now."

Hosted by Darshini Ayton and Sarah Carmody

Produced by Darshini Ayton

Music by Luke Champion

An initiative of the Centre of Research Excellence in Enhanced Dementia Diagnosis which is funded by the Australian National Health and Medical Research Council.

This podcast was recorded on Wurundjeri Country. We acknowledge the Traditional owners and custodians of the Wurundjeri Land, the Boonwurrung and the Woiwurrung peoples of the Kulin Nation. We pay our respect to their Elders past and present. Lands which Sovereignty was never ceded. Always was, always will be Aboriginal Lands.